Abstract
Traumatic pseudoaneurysms of the vertebral artery (VA) are uncommon vascular lesions and definitive management is often challenging. Between 0% and 8% of craniocervical fusions are complicated by VA injury. In these cases, preserving the vertebral artery while treating the pseudoaneurysm is the goal of any treatment option. We describe the second known case of a patient with and iatrogenic extracranial vertebral artery pseudoaneurysm treated effectively using the Pipeline Embolization Device (PED) (Ev3 Neurovascular, Irvine, CA). Although there have been only two cases reported, the use of flow-diverting stents appears to be efficacious for the treatment of non-actively bleeding traumatic pseudoaneurysms.
Highlights
Vertebral artery (VA) pseudoaneurysms arise most commonly due to blunt or penetrating trauma, following surgery, collagen vascular disease, or arterial dissection [1]
We describe the second known case of a patient with and iatrogenic extracranial vertebral artery pseudoaneurysm treated effectively using the Pipeline Embolization Device (PED) (Ev3 Neurovascular, Irvine, CA)
We describe the second reported case of iatrogenic vertebral artery pseudoaneurysm that was treated effectively using the PED
Summary
Vertebral artery (VA) pseudoaneurysms arise most commonly due to blunt or penetrating trauma, following surgery, collagen vascular disease, or arterial dissection [1]. Because it emerges from the transverse foramen and courses adjacent to C1, the extracranial segment (V3) of the VA is the most susceptible to iatrogenic damage. Iatrogenic VA injury has been reported to lead to pseudoaneurysm development. Despite the potential for such pseudoaneurysms to resolve spontaneously, they have been shown to rupture in 31% to 54% of cases [8]. It is critical to rapidly diagnose and treat these vascular lesions to minimize the risk of potential grave morbidity and mortality
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